晨尿与随机尿尿蛋白/肌酐比值在肾脏损害诊断中的价值

摘要

Objective To study the correlation between 24-hour urinary protein excretion(24hUp),24-hour urinary albumin(24hmAlb) and spot urine(Including the morning urine and random urine) protein/creatinine ratio(Up/Ucr),albumin/creatinine ratio(UmAlb/Ucr) in outpatients,and to evaluate the clinical application of Up/Ucr and UmAlb/Ucr in spot urine samples as a predictor of 24hUp and 24hmAlb in Nephropathy injury screening.Methods 24-hour urine collection,first morning and random urine specimens of each patients were collected from 104 outpatients. The urinary protein was tested by immunoturbidimetry,urinary albumin was tested by immune transmission turbidity and urinary creatinine was tested by the enzyme colorimetry method.Results There was a high significant correlation between Up/Ucr in first morning urine specimens and 24hUp(also UmAlb/Ucr and 24hmAlb),r=0.943,0.771,respectively.There was a high sensitivity and negative predictive value in first morning urine specimens.There were no significant differences between Up/Ucr in first morning urine specimens and Up/Ucr in random urine specimens. Conclusion There was a high significant correlation between Up/Ucr in first morning urine specimens(also in random urine specimens) and 24hUp.There was also a high sensitivity of the Up/Ucr ratio in spot urine and the Up/Ucr in spot urine samples can be used as an alternative to 24hUp in early screening and monitoring of the degree of renal injury for the population of outpatients and health checkup.%目的：通过观察门诊患者24 h尿蛋白（24hUp）、尿微量白蛋白（24hmAlb）与随机尿和晨尿尿蛋白/肌酐比值（Up/Ucr）及尿微量白蛋白/肌酐比值（UmAlb/Ucr）的相关性，来探讨采用随机尿或晨尿Up/Ucr与UmAlb/Ucr代替24hUp和24hmAlb用于肾病早期损伤筛查的可行性。方法：收集104例患者24 h尿、晨尿、随机尿尿液标本，尿蛋白测定采用免疫比浊法，尿微量白蛋白采用透射免疫比浊法，尿肌酐测定采用酶比色法。结果：晨尿Up/Ucr比值与24hUp和晨尿UmAlb/Ucr比值与24hmAlb具有良好的相关性，相关系数分别为r=0.943和0.771；晨尿UmAlb/Ucr和Up/Ucr比值有较高的诊断敏感度和阴性预测值；晨尿和随机尿液Up/Ucr之间差异无统计学意义（P＞0.05）。结论：随机尿和晨尿Up/Ucr比值与24hUp有良好的相关性，且具有很高的灵敏度，可以用随机尿或晨尿Up/Ucr代替24hUp用于门诊患者和健康查体人群的早期肾损伤程度的筛查和监测。